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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research Open Access Indonesian Journal of Medical Reviews Bioscientia Medicina : Journal of Biomedicine and Translational Research
Prima Kharisma Hayuningrat
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Sternotomy and Pericardiectomy in a Patient with Constrictive Pericarditis and Multiple Comorbidities: A Case Report Dedy Chandra Hariyono; Prima Kharisma Hayuningrat
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i6.1294

Abstract

Background: Constrictive pericarditis is a serious condition that can lead to heart failure. It is characterized by a thickened and scarred pericardium, which restricts the heart's ability to fill and pump blood effectively. The condition is often caused by infections, such as tuberculosis, but can also be caused by other factors, such as radiation therapy, heart surgery, or autoimmune diseases. A pericardiectomy, a surgical procedure to remove the thickened pericardium, is the definitive treatment for constrictive pericarditis. Case presentation: This case report describes a 57-year-old male patient with constrictive pericarditis and multiple comorbidities, including recent tuberculosis, pleural effusion, ascites, and cholelithiasis. The patient presented with symptoms of shortness of breath, swollen legs, and a swollen stomach. After a thorough evaluation, including imaging studies, the diagnosis of constrictive pericarditis was confirmed. The patient underwent a sternotomy and pericardiectomy procedure, which was successful in relieving his symptoms and improving his cardiac function. Conclusion: This case report highlights the successful management of constrictive pericarditis in a patient with multiple comorbidities. The case also emphasizes the importance of early diagnosis and timely intervention in patients with constrictive pericarditis.
Neutrophil-Lymphocyte Ratio as a Predictor of Ulcer Severity in Type 2 Diabetes Prima Budi Prayogi; Prima Kharisma Hayuningrat; Suharto Wijanarko; Hari Wujoso
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 3 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i3.718

Abstract

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder with increasing global prevalence, frequently complicated by foot ulcers. These ulcers present a significant burden, often leading to amputation and increased mortality. The neutrophil-lymphocyte ratio (NLR), a readily available marker of systemic inflammation, has emerged as a potential prognostic indicator in various diseases. This study investigated the correlation between NLR and the severity of foot ulcers in patients with T2DM. A retrospective, cross-sectional study was conducted, analyzing data from 60 patients with T2DM and foot ulcers admitted to Dr. Moewardi General Hospital, Surakarta, between January 1st, 2022, and December 31st, 2023. NLR was calculated from routine complete blood counts. Ulcer severity was graded using the Meggitt-Wagner classification. Statistical analysis included Spearman's rank correlation and Kruskal-Wallis tests. Our study found a significant correlation observed between NLR and ulcer severity (ρ = 0.524, p < 0.001), with NLR values increasing with ulcer grade. Amputation was significantly associated with ulcer severity (p=0.009). In conclusion, NLR is a valuable and readily available biomarker for assessing the severity of foot ulcers in patients with T2DM. Elevated NLR is associated with more severe ulcers and a higher likelihood of amputation. Incorporating the assessment of NLR into the routine evaluation of patients with diabetic foot ulcers can aid in risk stratification and guide clinical management.
Sternotomy and Pericardiectomy in a Patient with Constrictive Pericarditis and Multiple Comorbidities: A Case Report Dedy Chandra Hariyono; Prima Kharisma Hayuningrat
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i6.1294

Abstract

Background: Constrictive pericarditis is a serious condition that can lead to heart failure. It is characterized by a thickened and scarred pericardium, which restricts the heart's ability to fill and pump blood effectively. The condition is often caused by infections, such as tuberculosis, but can also be caused by other factors, such as radiation therapy, heart surgery, or autoimmune diseases. A pericardiectomy, a surgical procedure to remove the thickened pericardium, is the definitive treatment for constrictive pericarditis. Case presentation: This case report describes a 57-year-old male patient with constrictive pericarditis and multiple comorbidities, including recent tuberculosis, pleural effusion, ascites, and cholelithiasis. The patient presented with symptoms of shortness of breath, swollen legs, and a swollen stomach. After a thorough evaluation, including imaging studies, the diagnosis of constrictive pericarditis was confirmed. The patient underwent a sternotomy and pericardiectomy procedure, which was successful in relieving his symptoms and improving his cardiac function. Conclusion: This case report highlights the successful management of constrictive pericarditis in a patient with multiple comorbidities. The case also emphasizes the importance of early diagnosis and timely intervention in patients with constrictive pericarditis.
Malignant Pericardial Effusion in Lung Adenocarcinoma: When to Escalate from Pericardiocentesis to Open Pericardiostomy Ibnu Kharisman; Prima Kharisma Hayuningrat
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 6 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i6.810

Abstract

Malignant pericardial effusion (MPE) is a grave, life-limiting complication of advanced cancer, where lung adenocarcinoma is a leading cause. Its management is a cornerstone of palliative cardio-oncology, focused on alleviating debilitating dyspnea and enhancing the quality of remaining life. The optimal therapeutic pathway, especially following the failure of initial interventions, remains a critical challenge, demanding a careful balance between efficacy and treatment burden. A 58-year-old female with stage IV lung adenocarcinoma and a good baseline performance status (ECOG 1) presented with progressive, life-limiting dyspnea (NYHA Class IV). A massive pericardial effusion was diagnosed, and an initial pericardiocentesis provided only transient relief, with severe symptoms recurring within 48 hours. Following a multidisciplinary discussion centered on the patient’s goals of care, the decision was made to escalate to a definitive surgical procedure. A subxiphoid open pericardiostomy was performed, yielding hemorrhagic fluid and pericardial tissue that confirmed metastatic adenocarcinoma. The procedure resulted in complete, durable resolution of her symptoms. In conclusion, open pericardiostomy provides durable relief from the life-limiting dyspnea of MPE, a goal often unachievable with pericardiocentesis alone. For appropriately selected patients with advanced cancer, escalating to a definitive surgical procedure is not merely a treatment for effusion but a crucial intervention to restore function and dignity. This case underscores that for patients with recurrent MPE and adequate performance status, timely surgical intervention is a vital component of effective palliative care, maximizing quality of life.
Co-Authors Dedy Chandra Hariyono Hari Wujoso Ibnu Kharisman Prima Budi Prayogi Suharto Wijanarko